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Prospective candidates seeking employment at Allegheny Children's Initiative are required to produce 3 different criminal history background clearances at the time of their interview.  The three clearances, which must all be current (i.e. dated within the past 1 year), include:

1.)  Pennsylvania Child Abuse History Clearance (Act 33)

2.)  Pennsylvania State Police Request for Criminal Records Check (Act 34)  -and-

3.)  FBI Criminal Background Check (Act 73)

How do I obtain these clearances?

Pennsylvania Child Abuse History Clearance (Act 33)

  1. Takes approx. 3 weeks.
  2. Download the Pennsylvania Child Abuse History Clearance form (CY-113) (Adobe Reader required):

    http://www.dpw.state.pa.us/findaform/childabusehistoryclearanceforms/index.htm

  3. Complete Section I on that form:
    • Fill in all requested information (neatly/legibly)
    • Check off "Child Care" as the PURPOSE OF CLEARANCE
    • List all addresses at which you lived since 1975 (to the best of your recollection)
    • List all persons with whom you lived since 1975 (to the best of your recollection)
      • NOTE: If you are currently 58 or younger, you will need to include your parent(s) and/or guardian(s).  Failure to do so will probably result in your application being returned to you unprocessed!!
  4. Obtain a $10.00 Money Order, payable to DEPARTMENT OF PUBLIC WELFARE (Do not send cash or check).
  5. Send the completed form/money order to:

    Childline and Abuse Registry

    Department of Public Welfare

    P.O. Box 8170

    Harrisburg, Pa 17105-8170

Pennsylvania State Police Request for Criminal Records Check (Act 34)

Online Method (Pennsylvania State Police Website)

  1. Results are returned immediately (if no record exists).  Can take up to 5 weeks otherwise.
  2. Go to the ePatch website (Credit card required):

    https://epatch.state.pa.us/

  3. Click Submit a New Record Check under the Credit Card Users heading.
  4. Read and accept the terms, and continue to follow the instructions to submit your background check.
  5. If no record exists, you can immediately print out your clearance certificate.

Mail-in Method (Using Form SP4-164)

  1. Takes approx. 4-5 weeks.
  2. Download the Request for Criminal Records Check form (SP4-164):

    Microsoft Word version (fill-in form):

    https://epatch.state.pa.us/help/sp4164.doc

    Adobe Reader version (not a fill-in form):

    http://www.dpw.state.pa.us/findaform/childabusehistoryclearanceforms/index.htm

  3. From the top, down, complete the following:
    • Date of Request
    • Requester Name/Address (this is you)
    • Contact Telephone Number (your phone number)
    • Requester Identification (Check the first box, and fill in all requested information)
    • Reason For Request (Check "Employment" and "Child Care")
  4. Obtain a $10.00 Certified Check -or- Money Order, payable to COMMONWEALTH OF PENNSYLVANIA (Do not send cash or personal check).
  5. Send the completed form/certified check or money order to:

    Pennsylvania State Police

    Central Repository ? 164

    1800 Elmerton Avenue

    Harrisburg, Pa 17110-9758

FBI Criminal Background Check (Act 73)

  1. Takes approx. 1-3 weeks.
  2. Register for fingerprinting online at the Cogent website:

    https://www.pa.cogentid.com/index_dpw.htm

    • Under the "Registration" section, click on "Register Online" to open the online registration form
    • Select "Applicant Credit Card" or "Applicant Money Order" at the top of the online form
    • Select "Employment with a significant likelihood..." as the Reason Fingerprinted
    • Then complete all of the required Personal Information and click "Next" when finished
    • Print the confirmation page as you will need the confirmation or registration number when you go to get fingerprinted
  3. Get to one of the designated locations to get fingerprinted.  Fingerprint locations, their hours of operation, and a list of what you'll need to take with you can be found under the "Print Site Locations" section of the Cogent website.

Where can I find additional information?

You can find more information regarding all 3 clearances on the PA Department of Public Welfare website at the following address:

http://www.dpw.state.pa.us/findaform/childabusehistoryclearanceforms/index.htm

Human Resources
Criminal Background Clearances...
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